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form.jotform.com Open in urlscan Pro
35.201.118.58  Public Scan

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Submitted URL: https://turners99053.lt.acemlnc.com/Prod/link-tracker?redirectUrl=aHR0cHMlM0ElMkYlMkZmb3JtLmpvdGZvcm0uY29tJTJGMjMxNDEzNTc1OTgzMDU4&s...
Effective URL: https://form.jotform.com/231413575983058
Submission: On June 07 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

Name: form_231413575983058 — POST https://submit.jotform.com/submit/231413575983058

<form class="jotform-form" action="https://submit.jotform.com/submit/231413575983058" method="post" name="form_231413575983058" id="231413575983058" accept-charset="utf-8" autocomplete="on" novalidate="true"><input type="hidden" name="formID"
    value="231413575983058"><input type="hidden" id="JWTContainer" value=""><input type="hidden" id="cardinalOrderNumber" value="">
  <div role="main" class="form-all">
    <ul class="form-section page-section">
      <li id="cid_1" class="form-input-wide" data-type="control_head">
        <div class="form-header-group  header-large">
          <div class="header-text httal htvam">
            <h1 id="header_1" class="form-header" data-component="header">Employee Violence Prevention Act®&nbsp;</h1>
            <div id="subHeader_1" class="form-subHeader">HR Workplace </div>
          </div>
        </div>
      </li>
      <li class="form-line" data-type="control_fullname" id="id_3"><label class="form-label form-label-top form-label-auto" id="label_3" for="first_3"> Employee Name: <span class="form-required">*</span></label>
        <div id="cid_3" class="form-input-wide" data-layout="full">
          <div data-wrapper-react="true"><span class="form-sub-label-container" style="vertical-align:top" data-input-type="first"><input type="text" id="first_3" name="q3_employeeName[first]" class="form-textbox    validate[required]"
                data-defaultvalue="" autocomplete="section-input_3 given-name" size="10" value="" data-component="first" aria-labelledby="label_3 sublabel_3_first"><label class="form-sub-label" for="first_3" id="sublabel_3_first"
                style="min-height:13px" aria-hidden="false">First Name</label></span><span class="form-sub-label-container" style="vertical-align:top" data-input-type="last"><input type="text" id="last_3" name="q3_employeeName[last]"
                class="form-textbox    validate[required]" data-defaultvalue="" autocomplete="section-input_3 family-name" size="15" value="" data-component="last" aria-labelledby="label_3 sublabel_3_last"><label class="form-sub-label" for="last_3"
                id="sublabel_3_last" style="min-height:13px" aria-hidden="false">Last Name</label></span></div>
        </div>
      </li>
      <li class="form-line" data-type="control_email" id="id_4"><label class="form-label form-label-top form-label-auto" id="label_4" for="input_4"> Employee Email: <span class="form-required">*</span></label>
        <div id="cid_4" class="form-input-wide" data-layout="half"> <span class="form-sub-label-container" style="vertical-align:top"><input type="email" id="input_4" name="q4_employeeEmail" class="form-textbox     validate[Email,required]"
              data-defaultvalue="" style="width:310px" size="310" value="" data-component="email" aria-labelledby="label_4 sublabel_input_4"><label class="form-sub-label" for="input_4" id="sublabel_input_4" style="min-height:13px"
              aria-hidden="false">example@example.com</label></span> </div>
      </li>
      <li class="form-line" data-type="control_radio" id="id_5"><label class="form-label form-label-top form-label-auto" id="label_5" for="input_5"> I the above named employee agree and comply with policies <span
            class="form-required">*</span></label>
        <div id="cid_5" class="form-input-wide" data-layout="full">
          <div class="form-single-column" role="group" aria-labelledby="label_5" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input type="radio" aria-describedby="label_5"
                class="form-radio  validate[required]" id="input_5_0" name="q5_iThe" value="I Agree and comply"><label id="label_input_5_0" for="input_5_0">I Agree and comply</label></span></div>
        </div>
      </li>
      <li class="form-line" data-type="control_textbox" id="id_6"><label class="form-label form-label-top form-label-auto" id="label_6" for="input_6"> Submit Acknowledgment <span class="form-required">*</span></label>
        <div id="cid_6" class="form-input-wide" data-layout="half"> <span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_6" name="q6_submitAcknowledgment" data-type="input-textbox"
              class="form-textbox    validate[required]" data-defaultvalue="" style="width:310px" size="310" value="" data-component="textbox" aria-labelledby="label_6 sublabel_input_6"><label class="form-sub-label" for="input_6"
              id="sublabel_input_6" style="min-height:13px" aria-hidden="false">Enter your pass**** correctly to successfully authorize acknowledgment </label></span> </div>
      </li>
      <li class="form-line jf-required" data-type="control_captcha" id="id_7"><label class="form-label form-label-top form-label-auto" id="label_7" for="input_7"> Please verify that you are human<span class="form-required">*</span> </label>
        <div id="cid_7" class="form-input-wide jf-required" data-layout="full">
          <section data-wrapper-react="true">
            <div id="hcaptcha_input_7" class="h-captcha" data-sitekey="772f4a50-7161-425e-8cd5-4d7e361ab765" data-callback="hcaptchaCallbackinput_7" data-expired-callback="hcaptchaExpiredCallbackinput_7"><iframe
                src="https://newassets.hcaptcha.com/captcha/v1/2220dfa/static/hcaptcha.html#frame=checkbox&amp;id=08zpeifj50hq&amp;host=form.jotform.com&amp;sentry=true&amp;reportapi=https%3A%2F%2Faccounts.hcaptcha.com&amp;recaptchacompat=true&amp;custom=false&amp;hl=en&amp;tplinks=on&amp;sitekey=772f4a50-7161-425e-8cd5-4d7e361ab765&amp;theme=light&amp;origin=https%3A%2F%2Fform.jotform.com"
                tabindex="0" frameborder="0" scrolling="no" title="Widget containing checkbox for hCaptcha security challenge" data-hcaptcha-widget-id="08zpeifj50hq" data-hcaptcha-response=""
                style="width: 303px; height: 78px; overflow: hidden;"></iframe><textarea id="g-recaptcha-response-08zpeifj50hq" name="g-recaptcha-response" style="display: none;"></textarea><textarea id="h-captcha-response-08zpeifj50hq"
                name="h-captcha-response" style="display: none;"></textarea></div><input type="hidden" id="input_7" class="hidden validate[required]" name="hcaptcha_visible" required="">
            <script type="text/javascript" src="https://hcaptcha.com/1/api.js"></script>
            <script type="text/javascript">
              var hcaptchaCallbackinput_7 = function(token) {
                var hiddenInput = $("input_7");
                hiddenInput.setValue(1);
                if (hiddenInput.validateInput) {
                  hiddenInput.validateInput();
                }
              }
              var hcaptchaExpiredCallbackinput_7 = function() {
                var hiddenInput = $("input_7");
                hiddenInput.writeAttribute("value", false);
                if (hiddenInput.validateInput) {
                  hiddenInput.validateInput();
                }
              }
            </script>
          </section>
        </div>
      </li>
      <li class="form-line" data-type="control_button" id="id_2">
        <div id="cid_2" class="form-input-wide" data-layout="full">
          <div data-align="auto" class="form-buttons-wrapper form-buttons-auto   jsTest-button-wrapperField"><button id="input_2" type="submit" class="form-submit-button submit-button jf-form-buttons jsTest-submitField" data-component="button"
              data-content="">Submit</button></div>
        </div>
      </li>
      <li style="display:none">Should be Empty: <input type="text" name="website" value=""></li>
    </ul>
  </div>
  <script>
    JotForm.showJotFormPowered = "0";
  </script>
  <script>
    JotForm.poweredByText = "Powered by Jotform";
  </script><input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="231413575983058-231413575983058">
  <script type="text/javascript">
    var all_spc = document.querySelectorAll("form[id='231413575983058'] .si" + "mple" + "_spc");
    for (var i = 0; i < all_spc.length; i++) {
      all_spc[i].value = "231413575983058-231413575983058";
    }
  </script>
  <input type="hidden" name="event_id" value="1686167204341_231413575983058_r6s4MLs">
</form>

Text Content

 * EMPLOYEE VIOLENCE PREVENTION ACT® 
   
   HR Workplace
 * Employee Name: *
   First NameLast Name
 * Employee Email: *
   example@example.com
 * I the above named employee agree and comply with policies *
   I Agree and comply
 * Submit Acknowledgment *
   Enter your pass**** correctly to successfully authorize acknowledgment
 * Please verify that you are human*
   
 * Submit
 * Should be Empty: